A home health care service that brings urgent and other acute care into patients’ homes is expanding into Denton — and it could help alleviate strain on an overburdened hospital system.
DispatchHealth has partnered with Texas Health to expand its same-day services into Denton. Visits are similar to what patients would receive in an urgent care clinic or doctor’s visit and can address about 70% of concerns people visit emergency rooms for. With COVID-19 placing strain on hospitals, health professionals say the service can keep patients out of emergency centers, helping hospitals focus on those who need advanced care.
When patients have acute health concerns, they can call or request an appointment online, where they fill out an intake form. A team of two providers — a physician associate or nurse practitioner and a medical technician — is sent to the patient’s home, where they can run diagnostics such as blood and urine tests, conduct X-rays and ultrasounds and administer and prescribe medication. While providers are trained to determine if care needs to be escalated to a hospital setting, many of patients’ concerns can be addressed during the appointment.
Dispatch also can administer COVID-19 testing and offer supportive care for positive patients. Teams go into every appointment with personal protective equipment, so they can enter patients’ homes regardless of contagion levels.
“If the patient meets criteria for receiving monoclonal antibodies to treat COVID, they can start the process to get the patient treated before the patient becomes serious enough for hospitalization,” said Shawn Parsley, president and chief operations officer at Texas Health Physicians Group.
Monoclonal antibodies are lab-made proteins that help the immune system fight off viruses and other harmful antigens. Although monoclonal antibody therapy has been used for decades, use of the therapy for COVID-19 is considered investigational in mild to moderate cases that are at risk of progressing without intervention. The Food and Drug Administration issued an emergency use authorization for monoclonal antibody therapy Sotrovimab in May.
“With the authorization of this monoclonal antibody treatment, we are providing another option to help keep high-risk patients with COVID-19 out of the hospital,” said Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research, at the time of the authorization.
The treatment will be available starting Aug. 30 for patients whose Texas Health primary care physician makes a request for DispatchHealth to administer it, but it’s not yet widely available.
Still, COVID-19 care is just one service Dispatch offers.
“It’s very similar to maybe a typical clinical visit — we check vitals, we perform a history and physical exam based on their complaint,” DispatchHealth lead advanced practice provider Eric Gordon said. “We’ve got a variety of testing we can do and a lot of treatment options we bring with us, whether it’s a breathing treatment, oral medications, IV fluids, etc.”
The average range for visits is between 20 minutes and 1.5 hours, though clinicians will stay as long as needed to administer care, Gordon said. Providers can prescribe medication and bill insurance just like doctors’ offices, and most major insurance is accepted. They also typically follow up with primary care physicians after appointments, making sure care remains fluid.
DispatchHealth began in Denver in 2015 and has continued to expand since, seeing demand for services increase amid the pandemic. The service expanded into Dallas in 2018 and Fort Worth in 2019, with the Fort Worth site now handling patients throughout Denton.
Beyond the obvious advantages of avoiding traveling to providers, the “house call” model saves patients money compared with emergency room care, Gordon said. Costs are comparable to urgent care visits, and uninsured patients pay a flat fee of $275. Without insurance, ER visits can cost anywhere from $150 to $3,000 or more, depending on the level of care needed.
“On average, each patient we see is saving them a cost of between $1,100 and $1,700, and when you multiply that out over the number of patients we’ve seen since starting in DFW, we’ve saved patients over $26 million, collectively,” Gordon said.
It also allows providers to see if the patient’s environment could be contributing to existing health concerns in any obvious ways and allows them to spend more time thinking about care.
“We’ve actually got a little bit of time while we’re driving there to review some of the notes from the onboarding process, so it’s a very different environment from when somebody is coming to you and you really don’t know anything about that patient until you walk into the room,” DispatchHealth chief medical officer Phil Mitchell said.
Physicians can refer out to Dispatch, allowing them to coordinate care for patients that can’t get into the office right away. Dispatch teams also can perform medication checks and advanced care like in-home hospitalization.
“The physicians love it because it gives them the ability to take care of a patient immediately when they feel like somebody really needs to see this person as opposed to sending them to an emergency room, particularly in a time like now where we’re dealing with a pandemic and you really don’t want to send people to the emergency room, unless you have to,” Parsley said.
The Fort Worth office has four “rovers” who service the area for now, but demand for house call services is growing quickly, with Dispatch seeing record days this month, Mitchell said. Though the pandemic has made the need for this type of care more acute, he believes services like DispatchHealth will continue to grow.
“Patients want it, their physicians and advanced practice providers want it, the insurance companies want it — everybody wants this to happen in this way because overall it’s a better way to provide care,” Mitchell said. “It’s a triple win for all those involved, so I think it’ll just continue to grow, and that COVID was likely an accelerant to have people see how important this type of care is.”